Provider Demographics
NPI:1962517532
Name:COCAYNE, DENNIS R (DDS)
Entity type:Individual
Prefix:MR
First Name:DENNIS
Middle Name:R
Last Name:COCAYNE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:DENNIS
Other - Middle Name:R
Other - Last Name:COCAYNE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:2745 W CLAY
Mailing Address - Street 2:STE A
Mailing Address - City:ST. CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63301
Mailing Address - Country:US
Mailing Address - Phone:636-723-5882
Mailing Address - Fax:636-723-5889
Practice Address - Street 1:2745 W CLAY
Practice Address - Street 2:STE A
Practice Address - City:ST. CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63301
Practice Address - Country:US
Practice Address - Phone:636-723-5882
Practice Address - Fax:636-723-5889
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0120691223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery